2019 ATI PEDIATRICS EXAM PROCTORED WITH NGN|
VERIFIED QUESTIONS AND ANSWERS WITH DETAILED
RATIONALES|
A nurse is assessing the pain level of a 3 year old toddler. Which of the following assessment
scales should the nurse use?
a. FACES
b. Numeric
c. CRIES
d. Visual analog
A
The nurse should use the FACES pain rating scale for pediatric clients who are 3 years old and
older. This scale allows the toddler to point to the face that depicts their current level of pain.
The nurse can then determine the need for pain management.
A nurse is planning an educational program to teach parents about protecting their children from
sunburns. Which of the following instructions should the nurse plan to include?
a. "allow your child to play outside during the hours between 10:00am and 2:00pm."
b. "choose a waterproof sunscreen with a minimum SPF of 15."
c. "dress you child in loose weave polyester fabric prior to sun exposure."
d. "reapply sunscreen every 4 hours."
B
The nurse should instruct parents to avoid allowing their children to play outside during the
hours between 1000 and 1400 because the child is at greatest risk for developing a sunburn
during this time.
The nurse should instruct parents to apply a waterproof sunscreen with a minimum SPF of 15 for
children. The parents should apply the sunscreen prior to sun exposure to reduce the risk of
sunburn.
The nurse should instruct parents to dress their children in tight weave cotton fabric prior to sun
exposure to protect the skin from the sun.
The nurse should instruct parents to reapply sunscreen every 2 to 3 hr.
A nurse is performing hearing screenings for children at a community health fair. Which of the
following children should the nurse refer to a provider for a more extensive hearing evaluation?
,a. an 18 month old toddler who has unintelligible speech
b. a 3 month old infant who has exaggerated startle response
c. a 4 year old preschooler who prefers playing with others rather than alone
d. an 8 month old infant who is not yet making babbling sounds
D
The nurse should refer a toddler who does not possess intelligible speech by the age of 24
months to a provider for a more extensive evaluation of hearing.
The nurse should refer infants who are under the age of 4 months and lack a startle response to a
provider for a more extensive evaluation of hearing.
The nurse should refer a preschooler who prefers playing alone and avoids interaction with
others to a provider for a more extensive evaluation of hearing.
The nurse should refer an infant who is not making babbling sounds by the age of 7 months to a
provider for a more extensive evaluation of hearing.
A nurse in an emergency department is assessing a 3 month old infant who has rotavirus and is
experiencing acute vomiting and diarrhea. Which of the following manifestations should the
nurse identify as an indication that the infant has moderate to severe dehydration?
a. HR 124
b. increased tear production
c. sunken anterior fontanel
d. capillary refill 2 seconds
C
A heart rate of 124/min is within the expected reference range of 106 to 186/min for a 3- to the
5-month-old infant. The nurse should expect the infant who has moderate to severe dehydration
to have tachycardia.
An infant who has moderate to severe dehydration is more likely to have an absence of tears
rather than increased tear production.
The nurse should recognize that a sunken anterior fontanel is an indication of moderate to severe
dehydration due to the acute loss of fluid.
A capillary refill of 2 seconds is within the expected reference range of 2 seconds or less for a 3-
month-old infant. An infant who has moderate to severe dehydration is more likely to have a
delayed capillary refill of greater than 2 seconds.
,A nurse is providing teaching to the family of a school-age child who has juvenile idiopathic
arthrisis. Which of the following instructions should the nurse include in the teaching?
a. "limit movement of the child's large joints"
b. "encourage the child to perform independent self-care."
c. "provide the child with a soft mattress for sleeping."
d. "schedule a 2 hour daily nap for the child in the afternoon."
B
"Limit movement of the child's large joints."Large joints should be exercised regularly to
maintain mobility and strengthen muscles.
"Encourage the child to perform independent self-care."MY ANSWERThe nurse should teach
the family the importance of encouraging the child to perform independent self-care. This will
minimize the child's pain while maximizing mobility. Encouraging and praising the child's
efforts for independence will also increase their self-esteem.
"Provide the child with a soft mattress for sleeping."Children who have juvenile idiopathic
arthritis should sleep on a firm mattress to provide support in maintaining joints in a functional
position.
"Schedule a 2-hour daily nap for the child in the afternoon."Daytime naps are discouraged
because stiffness can occur quickly and easily with inactivity, and naps can interfere with
nighttime sleeping.
A nurse is planning care for a school age child who has a tunneled central venous access device.
Which of the following interventions should the nurse include in the plan?
a. use sterile scissors to remove the dressing from the site
b. irrigate each lumen weekly with 10 ml of 0.9% sodium chloride solution when not in use
c. access the site suing a noncoring angle needle
d. use a semipermeable transparent depressing to cover the site
D
The nurse should avoid the use of scissors when performing dressing changes because this can
result in the accidental cutting of the catheter.
The nurse should flush each lumen of the catheter with a heparin solution daily when not in use.
The nurse should use a non-coring angled or straight needle when accessing an implanted port.
The nurse should cover the site with a semipermeable transparent dressing to reduce the risk of
infection.
, A nurse is providing anticipatory guidance to the parent of a toddler. Which of the following
expected behavior characteristics of toddlers should the nurse include?
a. controls impulsive feelings
b. understands right from wrong
c. easily separates from parents for long periods of time
d. expresses likes and dislikes
D
Controlling impulsive feelings is expected behavior of school-age children. Toddler is more
likely to have difficulty controlling strong and impulsive feelings as they try to assert their
independence and gain control of situations.
Understanding right from wrong and modifying their behavior in response to others' expectations
is the expected behavior of preschoolers. Toddlers tend to have a great deal of curiosity and ask
many questions but are not able to fully understand what behaviors are right or wrong.
A toddler might be able to separate from their parents for a short period of time, but toddlers are
more likely to experience acute separation anxiety when separated from their parents for an
extended period of time. The toddler might offer resistance if they are left with a new babysitter
or at a new daycare center.
Nurses should include that expressing likes and dislikes is an expected behavior of toddlers. This
is the time in life when a toddler is developing autonomy and self-concept. They will try to assert
themselves and frequently refuse to comply. The parent should allow the child to have some
control, but also set limits for them so they learn from their behavior and learn to control their
actions.
A nurse is providing discharge teaching to the parent of a school age child who has moderate
persistent asthma. Which of the following instructions should the nurse include?
a. "you should give your child their salmeterol inhaler every 4 hours when they are having an
acute episode of wheezing."
b. "you should monitor your child's weight weekly while they are receiving inhaled
corticosteroids therapy."
c. "pulmonary function tests will be performed every 12-24 months to evaluate how your child is
responding to therapy."
d. "when using the peak expiratory flow meter, record your child's average of three readings."
C
"You should give your child their salmeterol inhaler every 4 hours when they are having an acute
episode of wheezing."The nurse should inform the parent that long-acting beta2 agonists are to
VERIFIED QUESTIONS AND ANSWERS WITH DETAILED
RATIONALES|
A nurse is assessing the pain level of a 3 year old toddler. Which of the following assessment
scales should the nurse use?
a. FACES
b. Numeric
c. CRIES
d. Visual analog
A
The nurse should use the FACES pain rating scale for pediatric clients who are 3 years old and
older. This scale allows the toddler to point to the face that depicts their current level of pain.
The nurse can then determine the need for pain management.
A nurse is planning an educational program to teach parents about protecting their children from
sunburns. Which of the following instructions should the nurse plan to include?
a. "allow your child to play outside during the hours between 10:00am and 2:00pm."
b. "choose a waterproof sunscreen with a minimum SPF of 15."
c. "dress you child in loose weave polyester fabric prior to sun exposure."
d. "reapply sunscreen every 4 hours."
B
The nurse should instruct parents to avoid allowing their children to play outside during the
hours between 1000 and 1400 because the child is at greatest risk for developing a sunburn
during this time.
The nurse should instruct parents to apply a waterproof sunscreen with a minimum SPF of 15 for
children. The parents should apply the sunscreen prior to sun exposure to reduce the risk of
sunburn.
The nurse should instruct parents to dress their children in tight weave cotton fabric prior to sun
exposure to protect the skin from the sun.
The nurse should instruct parents to reapply sunscreen every 2 to 3 hr.
A nurse is performing hearing screenings for children at a community health fair. Which of the
following children should the nurse refer to a provider for a more extensive hearing evaluation?
,a. an 18 month old toddler who has unintelligible speech
b. a 3 month old infant who has exaggerated startle response
c. a 4 year old preschooler who prefers playing with others rather than alone
d. an 8 month old infant who is not yet making babbling sounds
D
The nurse should refer a toddler who does not possess intelligible speech by the age of 24
months to a provider for a more extensive evaluation of hearing.
The nurse should refer infants who are under the age of 4 months and lack a startle response to a
provider for a more extensive evaluation of hearing.
The nurse should refer a preschooler who prefers playing alone and avoids interaction with
others to a provider for a more extensive evaluation of hearing.
The nurse should refer an infant who is not making babbling sounds by the age of 7 months to a
provider for a more extensive evaluation of hearing.
A nurse in an emergency department is assessing a 3 month old infant who has rotavirus and is
experiencing acute vomiting and diarrhea. Which of the following manifestations should the
nurse identify as an indication that the infant has moderate to severe dehydration?
a. HR 124
b. increased tear production
c. sunken anterior fontanel
d. capillary refill 2 seconds
C
A heart rate of 124/min is within the expected reference range of 106 to 186/min for a 3- to the
5-month-old infant. The nurse should expect the infant who has moderate to severe dehydration
to have tachycardia.
An infant who has moderate to severe dehydration is more likely to have an absence of tears
rather than increased tear production.
The nurse should recognize that a sunken anterior fontanel is an indication of moderate to severe
dehydration due to the acute loss of fluid.
A capillary refill of 2 seconds is within the expected reference range of 2 seconds or less for a 3-
month-old infant. An infant who has moderate to severe dehydration is more likely to have a
delayed capillary refill of greater than 2 seconds.
,A nurse is providing teaching to the family of a school-age child who has juvenile idiopathic
arthrisis. Which of the following instructions should the nurse include in the teaching?
a. "limit movement of the child's large joints"
b. "encourage the child to perform independent self-care."
c. "provide the child with a soft mattress for sleeping."
d. "schedule a 2 hour daily nap for the child in the afternoon."
B
"Limit movement of the child's large joints."Large joints should be exercised regularly to
maintain mobility and strengthen muscles.
"Encourage the child to perform independent self-care."MY ANSWERThe nurse should teach
the family the importance of encouraging the child to perform independent self-care. This will
minimize the child's pain while maximizing mobility. Encouraging and praising the child's
efforts for independence will also increase their self-esteem.
"Provide the child with a soft mattress for sleeping."Children who have juvenile idiopathic
arthritis should sleep on a firm mattress to provide support in maintaining joints in a functional
position.
"Schedule a 2-hour daily nap for the child in the afternoon."Daytime naps are discouraged
because stiffness can occur quickly and easily with inactivity, and naps can interfere with
nighttime sleeping.
A nurse is planning care for a school age child who has a tunneled central venous access device.
Which of the following interventions should the nurse include in the plan?
a. use sterile scissors to remove the dressing from the site
b. irrigate each lumen weekly with 10 ml of 0.9% sodium chloride solution when not in use
c. access the site suing a noncoring angle needle
d. use a semipermeable transparent depressing to cover the site
D
The nurse should avoid the use of scissors when performing dressing changes because this can
result in the accidental cutting of the catheter.
The nurse should flush each lumen of the catheter with a heparin solution daily when not in use.
The nurse should use a non-coring angled or straight needle when accessing an implanted port.
The nurse should cover the site with a semipermeable transparent dressing to reduce the risk of
infection.
, A nurse is providing anticipatory guidance to the parent of a toddler. Which of the following
expected behavior characteristics of toddlers should the nurse include?
a. controls impulsive feelings
b. understands right from wrong
c. easily separates from parents for long periods of time
d. expresses likes and dislikes
D
Controlling impulsive feelings is expected behavior of school-age children. Toddler is more
likely to have difficulty controlling strong and impulsive feelings as they try to assert their
independence and gain control of situations.
Understanding right from wrong and modifying their behavior in response to others' expectations
is the expected behavior of preschoolers. Toddlers tend to have a great deal of curiosity and ask
many questions but are not able to fully understand what behaviors are right or wrong.
A toddler might be able to separate from their parents for a short period of time, but toddlers are
more likely to experience acute separation anxiety when separated from their parents for an
extended period of time. The toddler might offer resistance if they are left with a new babysitter
or at a new daycare center.
Nurses should include that expressing likes and dislikes is an expected behavior of toddlers. This
is the time in life when a toddler is developing autonomy and self-concept. They will try to assert
themselves and frequently refuse to comply. The parent should allow the child to have some
control, but also set limits for them so they learn from their behavior and learn to control their
actions.
A nurse is providing discharge teaching to the parent of a school age child who has moderate
persistent asthma. Which of the following instructions should the nurse include?
a. "you should give your child their salmeterol inhaler every 4 hours when they are having an
acute episode of wheezing."
b. "you should monitor your child's weight weekly while they are receiving inhaled
corticosteroids therapy."
c. "pulmonary function tests will be performed every 12-24 months to evaluate how your child is
responding to therapy."
d. "when using the peak expiratory flow meter, record your child's average of three readings."
C
"You should give your child their salmeterol inhaler every 4 hours when they are having an acute
episode of wheezing."The nurse should inform the parent that long-acting beta2 agonists are to
